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r - <br /> ""��°�TYeoF �ONSTRUCTIOn <br /> everett PERMIT PERMIT NO. 11Z17 <br /> CIiY HALL 259�87a5 <br /> EVERETT. WA 98201 ❑ COMBINATION ❑ BUILDING XC—DcMECHANICAL ❑ PLUMBING <br /> O\YNER AIPIL FpORE55 CITY ZIP PMONE <br /> E. Gilberts 307 Pecks Drive Everett 98203 353-9153 <br /> � <br /> APCIIIiECt OR pE51GNEH MpIL ADDRE55 Clil' 21P PMONE <br /> G2NEFALCONiRAGiOR MAILADDRESS dTY ZIP PNONE L'CENSE/ <br /> Same <br /> 1.IECMFNICAI,�ONiPAqOR MAILAOpRE55 pTV 21P PHONE tICENSEI - <br /> 1 <br /> PLUMBINGCANTflACTOR MFI�ADORESS CRV IIP PHONE UCENSEI <br /> CLA55OF WOr,N <br /> CNEW CADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> \'AIUAT10N OF WORK <br /> f <br /> OESGRI�E\VOPN <br /> install fireplace insert <br /> PROPOSE�USE OF 2UILDING <br /> I HERE6Y CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> iecn�oeseaienor+oFFForenrvis��owoeiowoannneHFouAcoaies PLICATION AND KNOW THE SAME TO BE TRUF AND CORRECT. <br /> ALL PROVISIONS Of LAWS AND ORDINANCES GOVERNING THIS <br /> �ot e�oc�_ar TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NGT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LA\N REGULATING <br /> CONSTRUCTION Ofi THE PERFORMANCE OF CONSTRUCTION. <br /> JOBAD�RE55 SIGNAiUREOFCONiRACiORORAUiMORIZ DAGENt DATE <br /> 307 Pecks Drive X �� � � 11/5/82 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATEf�CLOSET�TOILET� AIR COND.UNITS-H.P.[A. <br /> �ATHTUB REFRIG6RATION UNITS-H.P.EA <br /> LAVA10fiY�WASH BASINI BOILERS-N.P.EA. <br /> SHOWER GAS FIREO A C. UNITS-TONNAGE EA. <br /> KITCHLN SINK 8 DISP. FOflCED AIR SYSTEhIS-B.T.U. M EA. <br /> DISITYlASHER WALL HEAT&RS-��S.U. ht <br /> LAUNORY TRAY UNIT HEATERS-B.T.U. fd <br /> CLOTHES WASHER EVAPpRATI�[COOLEHS <br /> WATER HEATER CLOTHESOHYERS <br /> URINAL VENTIIATIUN FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLWG UNIT- GF.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS-RAMLEADENS METAL PIREPLACE S CHIMNEY <br /> SINK(SERVICE-BAR,ETC.) <br /> SUB TOTAL SUB TOTAL f 7 S O <br /> PERMIT S PEHMIT S <br /> 70TAL FEE S TOTAL FEE S 17 S 0 <br /> SIDE YARD SET�ACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NURI6ER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑YES I]NO FEES VALUATION FEE <br /> TYPE OP WNST. OCCUPANCY GROUP N0.OF DWELUNG UNITS <br /> �UILDING 5 <br /> SIZE OF BLOG. NO.OF STORIES MA%.OCC.LOAD <br /> P�UMBING <br /> FIRE ZONE OASEMENT FIRE SPRINKLERS <br /> I REOUIRED MECHANICAL 1] SO - <br /> IJYES IINO <br /> APPROVALS BY OA7E O7HER <br /> 1. ENVIRONMENTAL CHECK LIST <br /> PENALTY U.B.C. <br /> 2. BUILDING PU1N5 SEC.303(a) <br /> 3. FIRE NYDRANT '�TA� 17 S O <br /> 4. FIRE PROTEGTION SYSTEM PERMIT VALIDIITION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS 15 VOUR PERMIT <br /> 5. GHADING 7 �y.. I <br /> 6. DRAINAGE 915 E t O I l.5 O --� Q_ + <br /> ci <br /> T. ENOIRONMEN?AL IMPi!:T STPTEMENT • � 1 - ' (V <br /> B. HEALTH DISTRICT • (i ��J �( �R�ti E I PT �"I <br /> APPLIGITION ACC.BY PU1NS CHECKED BY APPR.FOR ISSUANCE BY <br /> ' ' THANK YOU <br /> ADDRESS FILE � g � 81 <br />